Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
  • A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
  • A61L27/54—Biologically active materials, e.g. therapeutic substances
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
  • A61L27/14—Macromolecular materials
  • A61L27/16—Macromolecular materials obtained by reactions only involving carbon-to-carbon unsaturated bonds
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
  • A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
  • A61L27/52—Hydrogels or hydrocolloids
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P41/00—Drugs used in surgical methods, e.g. surgery adjuvants for preventing adhesion or for vitreum substitution
• • C—CHEMISTRY; METALLURGY
  • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
  • C08K—Use of inorganic or non-macromolecular organic substances as compounding ingredients
  • C08K5/00—Use of organic ingredients
  • C08K5/0008—Organic ingredients according to more than one of the "one dot" groups of C08K5/01 - C08K5/59
  • C08K5/0025—Crosslinking or vulcanising agents; including accelerators
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
  • A61L2300/60—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a special physical form
  • A61L2300/602—Type of release, e.g. controlled, sustained, slow
• • C—CHEMISTRY; METALLURGY
  • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
  • C08K—Use of inorganic or non-macromolecular organic substances as compounding ingredients
  • C08K3/00—Use of inorganic substances as compounding ingredients
  • C08K3/02—Elements
  • C08K3/08—Metals
• • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
  • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
  • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
  • Y10S524/00—Synthetic resins or natural rubbers -- part of the class 520 series
  • Y10S524/916—Hydrogel compositions

Definitions

• the organism is mammals.
• ne ⁇ b ⁇ dimymi 25 ne ⁇ b ⁇ dimymi ⁇ izi ⁇ - ⁇ imiches ⁇ imi ( ⁇ edelennaya ⁇ l ⁇ n ⁇ s ⁇ and ⁇ imiches ⁇ aya ine ⁇ n ⁇ s ⁇ , s ⁇ s ⁇ bn ⁇ s ⁇ ⁇ usad ⁇ e or nabu ⁇ aniyu ⁇ sle ⁇ mescheniya in ⁇ ganizm) and bi ⁇ l ⁇ giches ⁇ imi (bi ⁇ l ⁇ giches ⁇ aya ine ⁇ n ⁇ s ⁇ in chas ⁇ n ⁇ s ⁇ i, ⁇ su ⁇ s ⁇ vie ⁇ ea ⁇ tsii ⁇ zhoniya or in ⁇ y ⁇ anev ⁇ y ⁇ ea ⁇ tsii) sv ⁇ ys ⁇ vami. Otherwise, the material must have a format suitable for introducing it into the muscle tissue with minimal trauma for the patient’s organism.
• hydrogels on the main polylamide may be used. Izves ⁇ en gid ⁇ gel on ⁇ sn ⁇ ve s ⁇ lime ⁇ a a ⁇ ilamida me ⁇ ilen- with bis-a ⁇ ilamid ⁇ m in ⁇ aches ⁇ ve sshivayuscheg ⁇ agen ⁇ a, ⁇ isanny in ⁇ a ⁇ en ⁇ e ⁇ ⁇ e 2114578, for ⁇ ednaznachenny izg ⁇ vleniya ⁇ us ⁇ ali ⁇ a eyes s ⁇ de ⁇ zhaschy a 1: 1 0 wt.% And s ⁇ lime ⁇ a a ⁇ ilamida me ⁇ ilen 5-bis a ⁇ ilamida, in vzya ⁇ y ⁇ by weight of 100: 2.26, and 89 by weight of% of physiological production.
• P ⁇ i e ⁇ m ⁇ tsess s ⁇ lime ⁇ izatsii ⁇ v ⁇ dya ⁇ in ⁇ dnu s ⁇ adiyu, z ⁇ in ⁇ aches ⁇ ve ⁇ e ⁇ sidny ⁇ initsia ⁇ v ⁇ lime ⁇ izatsii is ⁇ lzuyu ⁇ mixture ⁇ e ⁇ sul ⁇ a ⁇ a amm ⁇ niya and ⁇ e ⁇ ame ⁇ ile ⁇ ilendiamina, and ⁇ aches ⁇ ve v ⁇ dn ⁇ y s ⁇ edy be ⁇ u ⁇ a ⁇ i ⁇ gennuyu v ⁇ du or ⁇ as ⁇ v ⁇ ⁇ l ⁇ ida na ⁇ iya.
• the hydrogel obtained by this method has an insufficient degree of crosslinking, which is due to the low temperature mode of operation
• the process of sompolimerization and its one-stage E ⁇ ⁇ iv ⁇ di ⁇ ⁇ bys ⁇ mu ⁇ as ⁇ aniyu s ⁇ edini ⁇ eln ⁇ y ⁇ ani in im ⁇ lan ⁇ i ⁇ vannny gel and ⁇ eg ⁇ bys ⁇ y usad ⁇ e and ⁇ ez ⁇ btsii ( ⁇ . ⁇ . ⁇ ek ⁇ eg e ⁇ .
• the hydrogel produced by this method contains unrelated molecules of methylethylenediamine, free ⁇ 2 radicals and a small amount of 1, it means 1 E ⁇ m ⁇ zhe ⁇ vyzyva ⁇ a ⁇ ivnuyu ase ⁇ iches ⁇ uyu v ⁇ s ⁇ ali ⁇ elnuyu ⁇ ea ⁇ tsiyu on ⁇ anney s ⁇ adii introduction gid ⁇ gelya in ⁇ ganizm (see. ⁇ . ⁇ ek ⁇ eg e ⁇ a ⁇ " ⁇ es ⁇ aYe ⁇ u ⁇ g ⁇ Shs ⁇ uasgu ⁇ at ⁇ e de ⁇ ⁇ gtasgu ⁇ a ⁇ zzie gez ⁇ ze!
• a hydrogel gel described in the patent 21 ° 2127129, containing 1, 0 to 8.0 wt.%, Is obtained, which contains a total of 99% of the total weight of 92% of the product. .
• the method of obtaining this material is also described in
• a further one task is to reduce the tissue response of the body to the implant by reducing the content of free radicals and cartridges in the hydraulic gel.
• 15 P ⁇ s ⁇ avlennye problem ⁇ esheny ⁇ em, ch ⁇ ⁇ edl ⁇ zhen ⁇ li ⁇ un ⁇ tsi ⁇ nalny bi ⁇ s ⁇ vmes ⁇ imy gid ⁇ gel, s ⁇ de ⁇ zhaschy ⁇ e ⁇ echn ⁇ -sshi ⁇ y s ⁇ lime ⁇ a ⁇ ilamida s ⁇ crosslinking agen ⁇ m and v ⁇ du, ⁇ y, s ⁇ glasn ⁇ iz ⁇ b ⁇ e ⁇ eniya in ⁇ aches ⁇ ve sshivayuscheg ⁇ agen ⁇ a s ⁇ de ⁇ zhi ⁇ mixture ⁇ , ⁇ '- me ⁇ ilen bis a ⁇ ilamida, ⁇ , ⁇ ' - ethylene-bis-acrylamide and 20% of the angle for the following ratio of weight percentages:
• the indicated biocompatible hydrogel contains bi-distilled and odorogenic water.
• the compatible hydrogel has a pH of 3.5-7.5.
• the indicated crosslinked compound is from 2.0 to 5 to 15.0 wt.% Of the total weight of the hydrogel.
• the indicated biocompatible hydrogel contains the following ratio of components in wt.%:
• the indicated biocompatible hydrogel may also contain the following ratio of components in wt.%: 15 Ukrilamida - 1, 3 - 15,
• the method may also be implemented when in stock.
• a crosslinking agent takes a mixture of ⁇ , ⁇ '- methylene bis acrylamide, ⁇ , ⁇ '- ethylene bis acrylamide, polyvinyl, vinylpyrrolidene and / or ethylene bis
• the gel is washed in hot water, which has a temperature of 70-110 ° C, for at least 3 hours, at a weight of 8-10: ⁇
• Green As a part of the initiative for the elimination of the charge, you must not consume water and / or 20 ammonia in quantities not exceeding 0.33 wt.% Of the total weight of the original.
• bidistilled and hazardous water is available.
• ⁇ a ⁇ izves ⁇ n ⁇ ma ⁇ e ⁇ ial as gid ⁇ gelya on ⁇ sn ⁇ ve s ⁇ lime ⁇ a 25 a ⁇ ilamida and sshivayuschi ⁇ agen ⁇ v ⁇ eds ⁇ avlyae ⁇ s ⁇ b ⁇ y ⁇ e ⁇ me ⁇ nuyu se ⁇ ⁇ e ⁇ echn ⁇ -sshi ⁇ g ⁇ s ⁇ lime ⁇ a a ⁇ ilamida s ⁇ crosslinking agen ⁇ ami in yachey ⁇ a ⁇ ⁇ y ude ⁇ zhivae ⁇ sya v ⁇ dnaya s ⁇ eda in ⁇ y s ⁇ de ⁇ zhi ⁇ sya ne ⁇ e neus ⁇ an ⁇ vlenn ⁇ e ⁇ liches ⁇ v ⁇ nesvyazann ⁇ g ⁇ initsia ⁇ a ⁇ lime ⁇ izatsii, ⁇ a ⁇ ⁇ a ⁇ ne ⁇ e, ⁇ a ⁇ zhe neu
• FIG. 16 - Hydro-gel absorbing method is a product available in the Russian Federation for Patent 21 ° 2127129 under the name “story ⁇ endeavour ⁇ ⁇ » »» ”; For example, they are made in the region of 4000-500 cm “1.
• the product extract is provided with a 5 hydrogel
• a photograph of a histologically-logged biopsy of a tissue of a cassia taken after 30 days of a free delivery is provided, which is available for use (200); 20 ig. 36 - phytogroup of a histological and biological biopsy of the shell, taken after 30 days after a direct injection of the hydrophobic gel “bypass”; in Fig. 4a, a photograph of a histologically harmless biopsy of a dog, taken after 9 months after a prompt injection of a hydro-pump, is provided;
• Fig. 4b phytogroup of histological and biological damage of a dog, taken after 9 months after a direct injection of the hydrophobic gel “bypass”; on ⁇ ig.5a ⁇ eds ⁇ avlena ⁇ g ⁇ a ⁇ iya gis ⁇ l ⁇ giches ⁇ g ⁇ s ⁇ eza bi ⁇ sii z ⁇ ⁇ ani chel ⁇ ve ⁇ a, vzya ⁇ y che ⁇ ez 12 months ⁇ sle subglandulya ⁇ n ⁇ y im ⁇ lan ⁇ atsii ⁇ edlagaem ⁇ g ⁇ gid ⁇ gelya for mamma ⁇ las ⁇ i ⁇ i ( ⁇ as ⁇ a gema ⁇ silin-e ⁇ zin ⁇ m, x 400), where ⁇ - s ⁇ edini ⁇ eln ⁇ annaya ⁇ a ⁇ sula,
• ⁇ - transcendental zone C is a fragment of a hydrogel
• ⁇ is a macrophage on the part of the capsule, a part of the implant
• the product is: - ⁇ rilamide (asgu ⁇ at ⁇ e): ⁇ 3 ⁇ ⁇ ⁇ , mol. weight 71.08, white crystalline product without a deposit; melting point 84.5 ° C; w ⁇ izv ⁇ ds ⁇ v ⁇ ⁇ i ⁇ my ⁇ dta ( ⁇ a ⁇ al ⁇ g " ⁇ ea ⁇ ivy for bi ⁇ imii and issled ⁇ vany in ⁇ blas ⁇ i es ⁇ es ⁇ venny ⁇ nau ⁇ » ⁇ , 1999, p 47, ⁇ a ⁇ al ⁇ zhny ⁇ ° ⁇ 8887.);
• the process is as follows: 15 For the preparation of a reactive mixture, bidistilled and antigenic water having a pH of 5.6 is taken.
• acrylamide and cross-linking agents for example, mixtures of ⁇ , ⁇ '-methylene-bis-acrylamide, ⁇ , ⁇ -ethylene-bis-acrylamide and a slight increase in the amount of 65 5: 0.2 - 6.5: 0.2 - 34.0: 0.1 - 3.0), or a mixture of ⁇ , ⁇ '-methylene bis acrylamide, ⁇ , ⁇ '-ethylene bis acrylamide , price, vinyl pyridolide or ethylene bis- (hydroxyethylenitrile) -acetate acid, or the sum of the last (taken in the given mass ratio at: 0.2 - 6.0: 6.0 - 6.0: - 6.0 - 6.0 0: 0.1 - 3.0: 0.1-2.5), and for this 25, the total mass of the original components in the industry is 2.0-15.0%. (Aromatic quantities in the mixture produce a hydrogel of different density and elasticity).
• the ready-to-use mixture is filtered through bactericidal suitable filters, for example, brand ⁇ 8273 with a size of 5 0.45 ⁇ , which is a unit of 90 °. After this incubation
• the level of dosing is not higher than 1, 0 (mg of dosing per 1 liter).
• the migration of the drug was no more than 0.12 mg / l and at a permissible level of 200 mg / l in drinking water;
• hydrogel For the production of hydrogel, 384 ml of bidistilled apirogenic water with a pH of 5.6 were taken and 13 g of acrylamide, 0.5 g of ⁇ , ⁇ '-methylene bis-acylamide, 2,3- ⁇ - ⁇ , and 0.2 g of rivals, ideal for biological purposes. Then in the original
• the resulting hydrogel was sterilized by autoclaving (at a temperature of 120 ° ⁇ and a pressure of 1, 2 atm.) For 20 minutes.
• Index of application for the methodology described in the "Medicine for Physical Chemistry", ⁇ ., 1974, pp.
• the resulting sample of the hydrogel had the following physical and chemical 15 characteristics:
• the present look is a colorless, polished, intense gel
• the level of dispersion is 0.1 (mg of bromine per 1 liter).
• tissue blocks 20 were fixed at 96 ° ethyl alcohol or neutral raspberry and poured into a paraffin.
• the capsule ⁇ (Fig. For) remains in the market. It is a large part of the connective tissue, the quantity of fibroids decreases in size, and in the remaining cells, the content of ⁇ ( ⁇ ) decreases. ⁇ The reserved area ⁇ Fragments from the gel remain, which are disposed of by the macrophages. The internal capsule rotation was partially sent out by the macros. ⁇ satin worship The following sections (60 and 90 days) of the capsule structure are not
• junction capsule around the implant is thicker than implantation of the claimed material.
• the internal capsule has a large number of malfunctioning and there is no significant loss of memory
• hydrogel - ontropypa (osteochemistry of hematoxylsine-eosin, ⁇ 400).
• this photo gel As can be seen from this photo gel, it is equipped with connecting rods, connecting fibers, markers, leukocytes, and separate neutral leukemia. Partial lysis of the gel and its resorption is noted.
• the “old” fibrous capsule is almost always reversed.
• the implant is equipped with a closed connective-cassule ⁇ without an internal fibroblastic word, which has a place in the cavity of the silicone.
• connecting-cable rods categories, markers, and short-circuit immunity waves
• Part of the methods has a large penile cytoplasm (active phagosis).
• the connecting tissue knit separates the gel near the capsule into fragments.
• hydrogel For the production of hydrogel, 870 ml of bidistilled apirogenic water, having ⁇ , 5, 6, was dissolved in it; 81; acrylamide, 1 1, 5 g, bis-acrylamide, 4.6 grams of alcohol. Then, in the initial solution, 8 ml of 15 mg of water were added to initiate the polymerization. The resulting mixture was filtered, as described in step 1, and placed on an incubation of 80 ° C for 2 hours, then we washed the gel at a standstill of 80 5 hours at a temperature of 125 ° C. 20 The resulting hydraulic gel was sterilized, as described in Example 1.
• Hydrogel had the following physical and chemical characteristics, which were divided in accordance with the methods indicated in Example 1:
• the present view is a palpable mild yellow gel; 25 Indication of investments - 1, 336; ⁇ - 4.0;
• the content of monomers of acrylamide and bisacrylamide is up to 0.4 ⁇ civil;
• the level of dispersion is 0.9 (mg of bromine per 1 liter); Bacteriostatic properties
• hydrogel gel was used for the plasticization of the external muscle. Hydrogel gel in a volume of 50 ml. was injected into the external muscle of a patient I., 42 years old, to eliminate the defect after an irradiated injury. The patient was observed in the aftercare period of 6 months. There were no distant phenomena and no currents. Gel was not available. The simplicity was achieved.
• Example 3. 5 For the production of the hydrogel, 972 ml of bidistilled apirogenic water with a pH of 5.6 was taken, 22.5 g acrylamide, 0.375 g ⁇ , ⁇ '-methylene bis--b réelle ⁇ - acrylamide, 0.06 g of poison and 0.065 g of ethylene bis (hydroxyethylenitrile) - tetracycide acid. Then, 2.5 g of ammonia sulfate was introduced into the original solution.
• Hydrogel had the following physical and chemical characteristics, which were divided in accordance with the methods indicated in Example 1:
• the present look is a colorless gel; 20 Indication of investments - 1, 334; ⁇ - 6.8;
• the content of the acromilamides is absent;
• the level of dispersion is 0.15 (mg of bromine per 1 liter).
• the pressure zone of bacteria growth is 1, 5 mm.
• hydrogel samples were implanted in a convenient dog and removed after 3 and 6 months.
• the proposed hydrogel which contains, as a crosslinking agent, a mixture of ⁇ , ⁇ '-methylene-bis-acrylamide, ⁇ , ⁇ -ethylene bis-5 acrylamide and 4 months of age, is 6 months old. 15% of water is consumed;
• the proposed hydrogel containing a cross-linking agent as a mixture of ⁇ , ⁇ '-methylene bis-acrylamide, ⁇ , ⁇ -ethylene bis acrylamide, ileus, and is non-toxic. 5% of water is consumed by implants, and after 6 months, 9% of water is consumed after implantation.
• a dry gel with a low dry content of up to 3% is easy to inject through the thinned needles and can be used to lay soft tissues.
• a dry gel with a low dry content of up to 3% is easy to inject through the thinned needles and can be used to lay soft tissues.
• the resulting hydrogel was used to maintain a handy patch and remove facial wrinkles. Hydrogel gel in a volume of 1 ml. a total of 47 years was introduced. The patient was observed in the after-treatment period for 12 months with periodic treatment times in one month. Distinctive and allergic phenomena have not been established. c. The desired cosmetic effect has been achieved.
• the resulting hydraulic gel was sterilized by autoclaving, as described in Example 1.
• the material had the following physical and chemical characteristics: its present appearance is a colorless, highly opaque, polucheznaya gel;
• composition of monomers 0.04 ⁇ transaction; 15
• the level of breakdown is 0.05 (mg of bromine per 1 liter).
• Bacteriological properties the pressure zone of bacteria growth is 2.0 mm.
• the resulting hydrogel was used to remove overspray. Hydrogel in the amount of 2 g was introduced by the patient, 27 years. Patient 20 was observed in the after-treatment period for 12 months with periodic treatment times in one month. There were no distant phenomena and no currents. The desired cosmetic effect has been achieved.
• hydrogel For the production of the hydrogel, 375 ml of bidistilled organic water was taken at a pH of 5.6, and 23.75 g of acrylamide, 1, 075 g ⁇ , ⁇ '-methylene-bis-aqylamide, 0.1, 0,1-methylamide, 0.1 were dissolved in it. , 0.03g. Then, 0.02 g of ammonium sulfide and 1 ml of 30% hydrogen peroxide were introduced into the initial solution. The resulting mixture was filtered, as described in Example 1, and placed on incubation Temp. 50 ° C for 16 hours, then wash the gel in 3.5 l of hot water and temperature 100 ° C for 4.0 hours and incubate another 1 hour at 130 ° C.
• the resulting hydraulic gel was sterilized by autoclaving, as described in Example 1.
• the material had the following physical and chemical characteristics: Appearance - colorless gel; The indicator of investments - 1, 348; ⁇ - 4.8; Density - 1, 0g / cm 3 ;
• the proposed hydrogel practically does not cause tissue reaction, does not cause sensitization of the organism, does not cause Disruptive and non-critical changes and may be used for endoprosthesis and commercial soft tissue repair, as well as for endorsement of the parts and accessories Compared with a known hydrogel -
• the proposed hydrogel has a lower low-tissue response of the organism to its implantation, a higher rate of implantation, and a lower degree of amenity.
• P ⁇ edlagaemy gid ⁇ gel m ⁇ zhe ⁇ by ⁇ is ⁇ lz ⁇ van ⁇ a ⁇ zhe in ⁇ aches ⁇ ve na ⁇ lni ⁇ elya ⁇ i izg ⁇ vlenii end ⁇ ez ⁇ v, s ⁇ de ⁇ zhaschi ⁇ ⁇ b ⁇ l ⁇ ch ⁇ u and na ⁇ lni ⁇ el and ⁇ a ⁇ zhe in ⁇ aches ⁇ ve de ⁇ for le ⁇ a ⁇ s ⁇ venny ⁇ ⁇ e ⁇ a ⁇ a ⁇ v ⁇ i dli ⁇ eln ⁇ m medi ⁇ amen ⁇ zn ⁇ m treatment na ⁇ ime ⁇ , ⁇ u ⁇ ley or abstsess ⁇ v and ⁇ aches ⁇ ve n ⁇ si ⁇ elya for ⁇ ul ⁇ ivi ⁇ vaniya ⁇ le ⁇ chel ⁇ ve ⁇

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